A Rare Presentation of Conjunctival Myxoma with Pain and Redness: Case Report and Literature Review

Abstract

Background: Conjunctival myxoma is a type of rare, benign tumor of mesenchymal cells, with fewer than 30 reported cases in the English literature. It is mostly an isolated occurrence but can sometimes be associated with systemic diseases such as Carney complex or Zollinger-Ellison syndrome. It is necessary in clinical practice to differentiate it from other similar lesions, such as amelanotic nevus, lymphangioma, myxoid liposarcoma, spindle-cell lipoma, myxoid neurofibroma, and rhabdomyosarcoma. Case Presentation: The usual presentation of conjunctival myxoma is a translucent, well-circumscribed, and painless conjunctival mass, but in this report we discuss an unusual case of conjunctival myxoma in a 47-year-old Taiwanese woman who presented initially with pain and redness. This atypical presentation complicated the diagnosis and the management at first. Surgical excision of the mass was performed. The mass was found to be a conjunctival myxoma. The patient subsequently underwent extensive evaluation but was found not to have any systemic diseases with known association with conjunctival myxoma. Conclusions: In summary, we present a case of conjunctival myxoma in a 47-year-old Taiwanese woman. The initial presentation with pain and redness was atypical for conjunctival myxoma. The lesion was successfully managed with complete excisional biopsy.

Primary conjunctival myxoma: case series and review of the literature

“…In our series, conjunctival myxoma affected younger patients (range 27–51 years), with a mean age of 40 years, and occurred more frequently in females. The bulbar conjunctiva was the most affected location, as previously reported by other authors . Two cases described in the literature formed part of systemic disease; one presented as a component of Carney complex, and the other presented in association with Zollinger–Ellison syndrome and abnormal atrial septum thickness .…”

“…The typical clinical presentation of myxoma is as a solitary, translucent, well‐circumscribed, yellow–pink, painless, conjunctival cystic or solid mass . In our study, the most frequent clinical diagnosis was conjunctival cyst, whereas, in the literature, conjunctival mass was considered.…”

“…Some authors consider that conjunctival myxoma differs clinically and histopathologically from extraocular myxomas of soft tissues in some respects. Conjunctival myxomas often have cyst‐like cavities, as noted in nine of the published cases . This phenomenon never occurs in extraocular myxomas.…”

“…Myxoid neurofibromas may have a similar clinical appearance, although they are not cystic. They show cells with spindle‐shaped nuclei, accompanied by wavy bundles of collagen, and can be part of systemic neurofibromatosis . Nerve sheath myxoma is very rare in the conjunctiva and ocular adnexa.…”

Conjunctival Myxoma: Case Report

“…Klinikte genellikle yavaş büyüyen ağrısız kitle olarak görülmektedir, ancak gözde kızarıklık, ağrı ile başvuran hastalar da bildirilmiştir. 4,5 Tümörün cerrahi işlem sonrasında görülebileceği savı öne sürülmüştür. 6,7 Makroskopik olarak solid-jelatinöz kıvamda kitle biçiminde-dir.…”